Tooth Enamel Loss at a Young Age

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My granddaughter is only 9 years old and already her permanent teeth have very little enamel. What can we do about this?

— Ann, Alabama

There are several reasons why a young person such as your granddaughter may lose a large amount of enamel. These include:

Heavy grinding and clenching of the teeth. This unconscious action can wear enamel down. Clues that this is occurring can often be seen (or heard) when the child is sleeping. The teeth may also appear to be losing their enamel and becoming very tiny and worn down.

A medical condition. Sometimes, problems that children are born with or develop cause inadequate amounts of enamel to be present. One example of this is called ectodermal dysplasia. Treatment must be carefully thought out and may be put off until the child reaches the late teen years, when it is decided whether permanent crowns or implants are necessary.

A highly acidic diet and/or regurgitation problem. Exposure to extra acid can cause enamel loss over time, though this is unlikely since your granddaughter is only 9.

Clearly, lack of enamel should be evaluated by an excellent dentist, oral pathologist, or oral surgeon, to determine the cause and to decide what can be done about it. Most dentists do not like to do anything permanent on young children, so it's possible that the condition may only need to be monitored at this time. A diagnosis and treatment plan, however, should certainly be established.

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